ASHWIN RAMANANDA PRABHU BDS - Dentist License in Illinois | # 018001533

ASHWIN RAMANANDA PRABHU BDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001533

License Status

NOT RENEWED

Business

N

First Name

ASHWIN

Middle

RAMANANDA

Last Name

PRABHU

Suffix

BDS

Business Name

ASHWIN RAMANANDA PRABHU BDS

Original Issue Date

12/28/2004

Effective Date

09/11/2006

Expiration Date

09/15/2006

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

11/03/2006